Volume 46, Issue 6, Pages 1119-1126 (June 2015) A prospective randomised study comparing TightRope and syndesmotic screw fixation for accuracy and maintenance of syndesmotic reduction assessed with bilateral computed tomography  Tero Kortekangas, Olli Savola, Tapio Flinkkilä, Sannamari Lepojärvi, Simo Nortunen, Pasi Ohtonen, Jani Katisko, Harri Pakarinen  Injury  Volume 46, Issue 6, Pages 1119-1126 (June 2015) DOI: 10.1016/j.injury.2015.02.004 Copyright © 2015 Elsevier Ltd Terms and Conditions

Fig. 1 CONSORT flow chart. Injury 2015 46, 1119-1126DOI: (10.1016/j.injury.2015.02.004) Copyright © 2015 Elsevier Ltd Terms and Conditions

Fig. 2 Intraoperative CT showing patients both ankles, normal side (A), operated (B). Axial scans reformatted parallel to tibial plafond in coronal and sagittal planes, and measurements made 1cm above proximal from joint space. Mean width of the syndesmosis: [(AW injured ankle−AW normal side)+(PW injured ankle−PW normal side)]/2, showing over 2mm side-to-side difference signifying malreduced syndesmosis. Injury 2015 46, 1119-1126DOI: (10.1016/j.injury.2015.02.004) Copyright © 2015 Elsevier Ltd Terms and Conditions

Fig. 3 An example of false positive finding of intraoperative CT in TightRope group. (A) Intraoperative CT shows a slight external rotation and posterior slide of the fibula probably due to flexible nature of fixation of TightRope. (B) Postoperative CT of the same patient with the ankle supported at 90° angle by a cast. The fibula rotates internally and syndesmosis reduces, which was also verified by open exploration intraoperatively. Injury 2015 46, 1119-1126DOI: (10.1016/j.injury.2015.02.004) Copyright © 2015 Elsevier Ltd Terms and Conditions